Caregivers of Alzheimer's patients have consistently noted that patients seem to regress, not only in the context of time, but also in physiological, psychological and social functioning. The purpose of this study is to develop and test behavioral and environmental interventions for patients in nursing home and special care units in various stages of Alzheimer's disease using Piaget's stages of cognitive development as a theoretical model for cognitive dysfunction. The proposed study will attempt to answer the following questions: 1. What is the relationship between Piaget's levels of cognitive development and levels of cognitive impairment in persons with Alzheimer's disease? 2. What is the effect of behavioral and environmental modification based on Piaget's model of cognitive development on: a. the number of problem behaviors exhibited b. the number, dose, frequency and side effects of psychotropic drug use in cognitively impaired patients with Alzheimer's disease? A descriptive correlational longitudinal design will be used to investigate the association between Piaget's levels of cognitive development and the cognitive impairment associated with the stages of Alzheimer's disease. In addition, comparative treatment-control groups will be assessed to test the effectiveness of behavioral and environmental modifications to manage problem behaviors associated with Alzheimer's disease. A total stratified random sample of 80 (2 groups of 40) will be selected from two nursing home and special care units. The control group will receive standard care; the treatment group will receive a combination of behavior and environmental modification in addition to a drug withdrawal protocol to gradually decrease the use of psychotropic medications. Data analysis will include frequency distributions and summary statistics. For each of the research questions, multivariate analysis of variance will be used.